endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2025-6-2-05endofocus-150Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWНарушения ритма сердца и сахарный диабет: что нужно знать клиницистуCardiac arrhythmias and diabetes mellitus: What a clinician needs to knowhttps://orcid.org/0000-0002-6891-1711НадыбинаМ. Н.NadybinaM. N.

Надыбина Маргарита Николаевна – аспирант кафедры эндокринологии

г. Москва

Margarita N. Nadybina – graduate student of the Department of endocrinology

Moscow

mita0098@gmail.comhttps://orcid.org/0000-0001-5512-6899УшановаФ. О.UshanovaF. O.

Ушанова Фатима Омариевна – к.м.н., доцент кафедры эндокринологии

г. Москва

Fatima O. Ushanova – C. Sci. (Med.), Associate Professor of the Department of endocrinology

Moscow

fati_2526@mail.ruhttps://orcid.org/0009-0008-9443-3961ИзмайловаТ. Я.IzmaylovaT. Ya.

Измайлова Тамара Ярагиевна – студентка

г. Москва

Tamara Y. Izmailova – student

Moscow

ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииPirogov Russian National Research Medical UniversityФГБОУ ВО «Российский университет медицины» Минздрава РоссииRussian University of Medicine20252506202562Кардиоэндокринология38–46Copyright © Надыбина М.Н., Ушанова Ф.О., Измайлова Т.Я., 20252025Надыбина М.Н., Ушанова Ф.О., Измайлова Т.Я.Nadybina M.N., Ushanova F.O., Izmaylova T.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/150

Несмотря на всестороннее изучение коморбидности сердечно-сосудистых заболеваний и сахарного диабета (СД), патогенетические механизмы и клиническое течение нарушений ритма сердца (НРС) при данной патологии требуют более детального исследования. НРС у пациентов с СД представляют собой серьезную клиническую проблему, являясь одним из ведущих факторов риска внезапной сердечной смерти. Патогенез аритмий при СД сложен и включает множество аспектов. Многочисленные факторы риска, в том числе хроническая гипергликемия, создают предпосылки для структурного ремоделирования миокарда – раннего маркера дисфункции сердечной мышцы. В то же время дисбаланс вегетативной нервной системы приводит к изменению электрической активности сердца и дисрегуляции ритма. Многообразие форм аритмий – наджелудочковых, желудочковых, брадиаритмий – определяет существенные диагностические и терапевтические трудности для медицинских специалистов и обусловливает необходимость комплексного подхода к обследованию этой категории пациентов. Понимание механизмов развития аритмий при СД необходимо для разработки эффективных методов профилактики и лечения. В представленном обзоре подробно рассмотрена патофизиология, лежащая в основе аритмий при СД, а также обозначены основные терапевтические цели для снижения риска аритмий и внезапной смерти у пациентов с СД.

Despite a comprehensive study of such comorbidities as cardiovascular diseases and diabetes mellitus (DM), the pathogenetic mechanisms and clinical course of cardiac arrhythmias in this pathology require more detailed research. Cardiac arrhythmias are the leading cause of sudden cardiac death in patients with diabetes, presenting a serious clinical problem. The pathogenesis of arrhythmias in DM is complex and multifaceted. Numerous risk factors, including chronic hyperglycemia, create a background for structural remodeling of the myocardium, which is an early marker of heart muscle dysfunction. Concurrently, dysregulation of the autonomic nervous system leads to significant changes in the electrical activity of the heart and causes rhythm disorders. The variety of arrhythmias, including supraventricular and ventricular arrhythmias as well as bradyarrhythmias, creates significant diagnostic and therapeutic challenges for medical professionals and necessitates an integrated approach to diagnosing this category of patients. Understanding the mechanisms of arrhythmia development in DM is crucial for their effective prevention and treatment. This review examines the pathophysiological mechanisms underlying arrhythmias in DM and identifies the main therapeutic goals for reducing the risk of sudden cardiac death.

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The authors declare that there are no conflicts of interest present.